Cat’s myriad symptoms make diagnosis difficult

Dr. John De JongSunday, September 09, 2012

Dear Dr. John,

My 12-year-old cat has been in and out of the vet’s office during the last two months and I am wondering if you can shed any light on the situation. She is a spayed cat and has been healthy all of her life until not too long ago when she seemed to develop a congested respiratory condition. She sounds like she is always snoring, and after an initial two courses of antibiotics that helped just a bit, she has gone on to lose a lot of weight — from 7 to 4 pounds — by basically starving herself! She has not eaten in weeks until just recently when a new vet started her on fluid therapy for dehydration, new antibiotics and a special food and calorie supplement, both of which I spend time getting her to eat. Recent blood tests showed mild signs of infection and a high level of calcium in her blood. What could be going on, and do you think she will return to normal?— I.J.

Dear I.J.,

This sounds like a confusing and difficult case to crack. Based on the limited information that I have, a few possibilities come to mind. Was she ever heavy? If so, a condition known as hepatic lipidosis or fatty liver could have developed that causes a cessation of appetite. You mention snoring and congestion as well as infection, which suggests the possibility of a respiratory infection, but I do not usually see a cat that loses almost 50 percent of their body weight due to this kind of problem. I am encouraged when you state that you are getting the cat to eat, which might help to get things back to normal. The fluid therapy should help with the dehydration, and the antibiotics should combat the infection detected in the blood work. As for the increased calcium, that may be due to bone resorption or a problem with the parathyroid gland. There are specific tests that may help eliminate those possibilities. In the back of my mind, I cannot help but wonder about the possibility of a nasal mass that, despite the lack of nose bleeds, may be causing the snoring and the decrease in appetite. I would suggest you speak with your veterinarian about skull X-rays or a CT scan, the use of an appetite stimulant, and see what else they have in mind if they have not already suggested these possibilities. As to whether she will return to normal, that will depend on the proper diagnosis and how she responds to any treatments including what you are now doing. Good luck!